DR. GLEN Y KISHI MD
NPI 1174561765
Obstetrics & Gynecology in Phoenix, AZ
About Dr. Glen Y Kishi Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. GLEN Y KISHI MD (NPI 1174561765) is an individual obstetrics & gynecology provider in Phoenix, Arizona, licensed in Arizona (18565) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS and is a graduate of Un Of California, Irvine, College Of Medicine (1985).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 3
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Glen Y Kishi Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
3Medicare enrollment records show Glen Kishi reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Phoenix, AZ 85016
- Reassigned Medicare billing, Texas enrollment
- 599 clinicians in this Medicare group
Peach Springs, AZ 86434
- Reassigned Medicare billing, Texas enrollment
- 210 clinicians in this Medicare group
Moapa, NV 89025
- Reassigned Medicare billing, Texas enrollment
- 143 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 85016 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Glen Kishi's NPI number?
The NPI number for Glen Kishi is 1174561765. It was assigned to this individual provider in the NPPES registry on June 3, 2006.
Where is Glen Kishi located?
Glen Kishi practices at 4212 N 16th St, Phoenix, AZ 85016. The listed phone number is (602) 263-1200.
What is Glen Kishi's specialty?
The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.
Is Glen Kishi enrolled in Medicare?
Yes. Glen Kishi is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Glen Kishi's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Glen Kishi reassigns Medicare benefits to 3 organizations: Dhew Ind Hlth Sv Hlth Svs & Mntl Hlth Adm (Phoenix, AZ), Dhhs Ihs Phoenix Area (Peach Springs, AZ) and Irene Benn Medical Center (Moapa, NV). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Glen Kishi's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Glen Kishi was last updated on October 13, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. Glen Y Kishi, MD · NPI 1174561765
Obstetrics & Gynecology physician in Phoenix, Arizona. Individual provider, active in the CMS NPPES registry since June 3, 2006.
## Identity
- **NPI:** 1174561765 (Entity type: Individual)
- **Enumerated:** June 3, 2006
- **Primary specialty:** Obstetrics & Gynecology · taxonomy 207V00000X
- **State license:** 18565 (Arizona)
- **Sole proprietor:** No
## Practice location
- **Address:** 4212 N 16TH ST, Phoenix, AZ 85016-5319
- **Phone:** (602) 263-1200
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Dhew Ind Hlth Sv Hlth Svs & Mntl Hlth Adm (NPI 1083643738, Phoenix, AZ); Dhhs Ihs Phoenix Area (NPI 1265719934, Peach Springs, AZ); Irene Benn Medical Center (NPI 1841535317, Moapa, NV) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Un Of California, Irvine, College Of Medicine, class of 1985
## Record status
- **NPPES last updated:** October 13, 2015
- **Other identifiers:** Medicaid 285818 (AZ); Medicare PIN Z131775; Medicare UPIN E52285
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Source: [NPI Profile](https://npiprofile.com/npi/1174561765) · Data from the CMS NPPES public registry.